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Exhibit No. 1 to Subpart O [§ 502.252] of Part 502—Reparation Statement To Be Filed Pursuant to Rule 252

Reparation Statement To Be Filed Pursuant to Rule 252

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  3. Title 46
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  5. Chapter IV
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  7. Part 502
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  9. Subpart O
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  11. Appendix Exhibit No. 1 to Subpart O [§ 502.252] of Part 502
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Displayed edition2026-04-24
Last updated2026-04-24

Exhibit No. 1 to Subpart O [§ 502.252] of Part 502—Reparation Statement To Be Filed Pursuant to Rule 252

Claim of ____________________ under the decision of the Federal Maritime Commission in Docket No. ____________________.

Date of B/LDate of delivery or tender of deliveryDate charges paidVesselVoyage No.Port of originDestination portRouteCommodityWeight or measurementAs chargedShould beReparationCharges paid by *
RateAmountRateAmount
*Here insert name of person paying charges in the first instance, and state whether as consignor, consignee, or in what other capacity.
Total amount of reparation $________________________________________.
The undersigned hereby certifies that this statement has been checked against the records of this company and found correct.
Date ________________________________________.
________________________________________ Steamship Company, Collecting Carrier Respondent,
By ________________________________________, Auditor
By ________________________________________, Claimant
________________________________________, Attorney
(address and date)